HUBUNGAN ANTARA ENDOMETRIOSIS FERTILITY INDEX (EFI) DAN KEBERHASILAN FERTILISASI IN VITRO (FIV)

Adelina Amelia, Djaswadi Dasuki, Heru Pradjatmo
In: Jurnal Kesehatan Reproduksi · 2014 · vol. 1(2) · doi:10.22146/jkr.5334 · W2284444117
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This retrospective study found no statistically significant difference in IVF success rates between high and low Endometriosis Fertility Index groups, but embryo transfer type did influence outcomes.

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This retrospective cohort study assessed the relationship between the Endometriosis Fertility Index (EFI) and IVF outcomes among endometriosis patients undergoing IVF at Permata Hati, Dr. Sardjito Hospital, Yogyakarta in 2012, analyzing 54 cycles from 54 couples with EFI categorized into high vs low using an ROC-derived cutoff of 6. The study found no statistically significant difference in IVF success between high and low EFI groups (biochemical pregnancy, clinical pregnancy, and live birth; OR 15.135, 95% CI 0.830–276.00; p=0.067), though the high-EFI group showed a clinically larger effect size. IVF outcome was influenced by the type of embryo transfer (reported OR 0.126 in one section and OR 7.020 in the abstract; p=0.023), while female infertility cause and endometriosis stage increased EFI scores without affecting IVF outcomes. This paper is centrally about endometriosis — it tests whether EFI predicts IVF success in endometriosis patients.

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Abstract

Adelina Amelia 1 , Djaswadi Dasuki 2 , Heru Pradjatmo 3 Background: Endometriosis is a gynecological disease that is found in 25-30% of infertile women. The most widely used staging system of endometriosis in IVF is the revised American Fertility Society (r-AFS) which has limited predictive ability for pregnancy after surgery. The Endometriosis Fertility Index (EFI) is used to predict fecundity after endometriosis surgery . Objective: To assess the relationship between EFI and the outcomes of IVF. Methods: The study was retrospective cohort. Subjects of study were endometriosis patients who underwent IVF in Infertility Clinic of Permata Hati, Dr. Sardjito Hospital, Yogyakarta in 2012 that met inclusion and exclusion criteria. Subjects were devided into two groups: high EFI and low EFI. ROC curve was used to obtain the cut-off point . Chi-square and logistic regression statistics analysis were used. Results and Discussion: A total of 54 cycles from 54 couples who underwent IVF were included. Cut off point for EFI is 6. There is no difference in the outcomes of IVF between high and low EFI (OR 15,135; 95% CI 0,830-276,00; p=0,067), but high EFI increased the outcome of IVF 15 times better than low EFI. The outcome of IVF was influenced by type of the embryo transfer (OR 0,126; 95% CI 0,028-0,566). Conclusion: High EFI did not affect the outcomes of IVF both rated at biochemical pregnancy, clinical pregnancy and live birth. The outcomes of IVF was influenced by type of the embryo transfer. The cause of female infertility and stage of the endometriosis increased EFI score but did not affect the outcomes of IVF. Keyword: endometriosis, infertility, endometriosis fertility index, in vitro fertilization ABSTRAK Latar Belakang: Endometriosis adalah salah satu penyakit ginekologi yang ditemukan pada 25-50% wanita infertil. Sistim klasifikasi yang digunakan untuk menentukan derajat atau stadium endometriosis dalam FIV yaitu The revised American Fertility Society ( r-AFS ) yang memiliki keterbatasan dalam memprediksikan kehamilan setelah pembedahan . Endometriosis Fertility Index ( EFI ) adalah sistim klasifikasi endometriosis terbaru yang dapat digunakan untuk memprediksikan kehamilan setelah pembedahan. Tujuan: Menilai hubungan antara Endometriosis Fertility Index (EFI) dan keberhasilan Fertilisasi In Vitro (FIV). Metode : Studi kohor retrospektif . Subyek penelitian adalah pasien endometriosis yang menjalani program FIV di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta pada tahun 2012 yang memenuhi kriteria inklusi dan terlepas dari kriteria ekslusi. Subyek dibagi menjadi 2, kelompok EFI tinggi dan EFI rendah. Nilai titik potong EFI didapat dari kurva ROC. Uji statistik yang digunakan adalah Chi-square dan regresi logistik. Hasil dan Pembahasan: Sebanyak 54 siklus dari 54 pasangan yang menjalani fertilisasi in vitro (FIV) disertakan dalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Nilai titik potongditetapkan EFI = 6. Tidak terdapat perbedaan secara statistik terhadap keberhasilan FIV antara EFI tinggi dan rendah ( OR 15,135; IK 95% 0,830-276,00; p=0,067) tetapi secara klinis skor EFI tinggi meningkatkan keberhasilan FIV 15 kali dibanding skor EFI rendah. Keberhasilan FIV dipengaruhi oleh jenis embrio yang ditransfer ( OR 7,020; IK 95% 1,309-37,660; p=0,023). Kesimpulan: Skor EFI tinggi tidak mempengaruhi keberhasilan dalam program FIV baik dinilai pada kehamilan biokimia, kehamilan klinik, maupun kelahiran bayi hidup. Faktor yang mempengaruhi adalah jenis embrio yang ditransfer. Faktor penyebab infertilitas wanita dan stadium endometriosis meningkatkan skor EFI tetapi tidak mempengaruhi keberhasilan FIV. Kata kunci : endometriosis, infertilitas, endometriosis fertility index,fertilisasi in vitro. 1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM
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Abstract

Adelina Amelia1, Djaswadi Dasuki2, Heru Pradjatmo3

Background

Endometriosis is a gynecological disease that is found in 25-30% of infertile women. The most widely used staging system of endometriosis in IVF is the revised American Fertility Society (r-AFS) which has limited predictive ability for pregnancy after surgery. The Endometriosis Fertility Index (EFI) is used to predict fecundity after endometriosis surgery.

Objective

To assess the relationship between EFI and the outcomes of IVF.

Methods

The study was retrospective cohort. Subjects of study were endometriosis patients who underwent IVF in Infertility Clinic of Permata Hati, Dr. Sardjito Hospital, Yogyakarta in 2012 that met inclusion and exclusion criteria. Subjects were devided into two groups: high EFI and low EFI. ROC curve was used to obtain the cut-off point.Chi-square and logistic regression statistics analysis were used.

Results

and Discussion: A total of 54 cycles from 54 couples who underwent IVF were included. Cut off point for EFI is 6. There is no difference in the outcomes of IVF between high and low EFI (OR 15,135; 95% CI 0,830-276,00; p=0,067), but high EFI increased the outcome of IVF 15 times better than low EFI. The outcome of IVF was influenced by type of the embryo transfer (OR 0,126; 95% CI 0,028-0,566).

Conclusion

High EFI did not affect the outcomes of IVF both rated at biochemical pregnancy, clinical pregnancy and live birth. The outcomes of IVF was influenced by type of the embryo transfer. The cause of female infertility and stage of the endometriosis increased EFI score but did not affect the outcomes of IVF.

Keyword

endometriosis, infertility, endometriosis fertility index, in vitro fertilization ABSTRAK Latar Belakang: Endometriosis adalah salah satu penyakit ginekologi yang ditemukan pada 25-50% wanita infertil. Sistim klasifikasi yang digunakan untuk menentukan derajat atau stadium endometriosis dalam FIV yaitu The revised American Fertility Society (r-AFS) yang memiliki keterbatasan dalam memprediksikan kehamilan setelah pembedahan. Endometriosis Fertility Index ( EFI) adalah sistim klasifikasi endometriosis terbaru yang dapat digunakan untuk memprediksikan kehamilan setelah pembedahan. Tujuan: Menilai hubungan antara Endometriosis Fertility Index (EFI) dan keberhasilan Fertilisasi In Vitro (FIV). Metode: Studi kohor retrospektif. Subyek penelitian adalah pasien endometriosis yang menjalani program FIV di Klinik Permata Hati RSUP Dr. Sardjito Yogyakarta pada tahun 2012 yang memenuhi kriteria inklusi dan terlepas dari kriteria ekslusi. Subyek dibagi menjadi 2, kelompok EFI tinggi dan EFI rendah. Nilai titik potong EFI didapat dari kurva ROC. Uji statistik yang digunakan adalah Chi-square dan regresi logistik. Hasil dan Pembahasan: Sebanyak 54 siklus dari 54 pasangan yang menjalani fertilisasi in vitro(FIV) disertakan dalam penelitian sesuai dengan kriteria inklusi dan eksklusi. Nilai titik potongditetapkan EFI=6. Tidak terdapat perbedaan secara statistik terhadap keberhasilan FIV antara EFI tinggi dan rendah (OR 15,135; IK 95% 0,830-276,00; p=0,067) tetapi secara klinis skor EFI tinggi meningkatkan keberhasilan FIV 15 kali dibanding skor EFI rendah. Keberhasilan FIV dipengaruhi oleh jenis embrio yang ditransfer (OR 7,020; IK 95% 1,309-37,660; p=0,023). Kesimpulan: Skor EFI tinggi tidak mempengaruhi keberhasilan dalam program FIV baik dinilai pada kehamilan biokimia, kehamilan klinik, maupun kelahiran bayi hidup. Faktor yang mempengaruhi adalah jenis embrio yang ditransfer. Faktor penyebab infertilitas wanita dan stadium endometriosis meningkatkan skor EFI tetapi tidak mempengaruhi keberhasilan FIV. Kata kunci: endometriosis, infertilitas, endometriosis fertility index,fertilisasi in vitro. 1,2,3 Bagian Obstetri dan Ginekologi, Fakultas Kedokteran UGM

Keywords

Full Text: PDF (Bahasa Indonesia)DOI: https://doi.org/10.22146/jkr.5334 Article Metrics

Abstract

views : 7617 | views : 3194Refbacks - There are currently no refbacks. Copyright (c) SEKRETARIAT JURNAL KESEHATAN REPRODUKSI Departemen Obstetri dan Ginekologi, FK-KMK, UGM/RS Dr. Sardjito Jl. Kesehatan No. 1, Sekip Utara, Yogyakarta 55281 Email: [email protected] Cp: Admin Jurnal +6282146143990

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